Increased Restenosis Rate After Implantation of Drug-Eluting Stents in Patients With Elevated Serum Activity of Matrix Metalloproteinase-2 and -9

ABSTRACTObjective: This study was designed to evaluate the hepatoprotective and antioxidant effects of methanolic extract of Calligonum comosum (C. comosum)shoots on the hepatic fibrosis induced by carbon tetrachloride and ethanol (CCl4/ethanol) in rats.Methods: A liver fibrosis was induced in Sprague Dawley rats by oral administration of CCl4 (1 ml/kg body weight, twice weekly for 10 weeks) alongwith ethanol (10% in drinking water 1 week before CCl4 administration and throughout the experiment). Rats were pretreated with C. comosumextract (daily, orally at a dose of 50 mg/kg body weight 1 week before CCl4 administration). At the end of the experiment, serum, and liver sampleswere subjected to biochemical investigations. In addition, liver and kidney tissues were evaluated for histopathological changes.Results: C. comosum extract pretreatment significantly reduced CCl4 - induced elevation in serum levels of aspartate aminotransaminase, alanineaminotransaminase, alkaline phosphatase, total bilirubin, urea, creatinine, and significantly elevated serum contents of total protein and albumin, aswell as an improvement in hepatic protein content, albumin/globulin ratio, body weight and relative liver and kidney weights. C. comosum extract alsosignificantly increased the hepatic levels of glucose-6-phosphatase, glutathione peroxidase, glutathione-S-transferase, catalase, superoxide dismutase,and glutathione with significant decrease in the contents of malondialdehyde and protein carbonyl. In addition, downregulation in expression ofthe fibrotic marker matrix metalloproteinase-2 was observed. C. comosum extract also ameliorated histopathological changes of CCl4/ethanol groupwhich further evidenced the biochemical findings.Conclusion: Our results confirmed that the methanolic extract of C. comosum shoots effectively protect against CCl4/ethanol-induced liver fibrosis,through its antioxidant property.Keywords: Calligonum comosum, Hepatic fibrosis, Carbon tetrachloride, Hepatoprotective effect, Antioxidants, Matrix metalloproteinase-2.

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Differences in Restenosis Rate With Different Drug-Eluting Stents in Patients With and Without Diabetes Mellitus

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2009.01.054 ◽

2009 ◽

Vol 53 (18) ◽

pp. 1660-1667 ◽

Cited By ~ 67

Author(s):

Ole Fröbert ◽

Bo Lagerqvist ◽

Jörg Carlsson ◽

Johan Lindbäck ◽

Ulf Stenestrand ◽

...

Keyword(s):

Diabetes Mellitus ◽

Drug Eluting Stents ◽

Restenosis Rate ◽

Drug Eluting

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Stents in interventional cardiology

Medicina ◽

10.3390/medicina43030022 ◽

2007 ◽

Vol 43 (3) ◽

pp. 183 ◽

Cited By ~ 2

Author(s):

Virgilijus Grinius ◽

Ramūnas Navickas ◽

Ramūnas Unikas

Keyword(s):

Stent Thrombosis ◽

Coronary Angioplasty ◽

Interventional Cardiology ◽

Percutaneous Transluminal Coronary Angioplasty ◽

Coronary Stenting ◽

Drug Eluting Stents ◽

Restenosis Rate ◽

Drug Eluting ◽

Transluminal Coronary Angioplasty ◽

Percutaneous Transluminal

Since the first percutaneous transluminal coronary angioplasty performed by A. Gruentzig in 1977, percutaneous coronary interventions have become the most important treatment modality for coronary heart disease. Coronary angioplasty carried a significant risk of coronary flow-limiting dissections and restenosis during the first six months following the procedure. Two main studies comparing percutaneous transluminal coronary angioplasty and coronary stenting (STRESS and BENESTENT) performed in 1994 showed a significant reduction in restenosis rate using stents. Thus, until now stents are the most widely used devices for coronary intervention despite two problems: subacute stent thrombosis (1–2%) and still high restenosis rate (5–40%). Subacute stent thrombosis occurs within the first month after stent placement and can be prevented using the double antiplatelet regimen with aspirin and clopidogrel. Some risk of subacute thrombosis remains beyond the first month when drug-eluting stents are used. This requires prolonged antiplatelet therapy. Drugeluting stents are the most significant innovation in interventional cardiology. They can reduce the incidence of restenosis in native stable coronary arteries to 3–5%. However, the long-term studies comparing bare-metal stents and drug-eluting stents did not show any significant differences in the rate of major adverse cardiac events (death, myocardial infarction), especially in patients with diabetes after the treatment of bifurcational lesions. According to proposed recommendations, drug-eluting stents should be used in small vessels, restenotic lesions, and in saphenous vein grafts. Despite some disadvantages, the results of coronary stenting using drugeluting stents continue to improve.

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